Ab-Interno Ocular Delivery for Schlemm’s Canal Dilation
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Solution Overview
Problem
Current methods for accessing Schlemm's canal, such as viscocanalostomy and canaloplasty, are invasive and challenging due to their ab-externo approach, making it difficult to dilate the canal effectively and increase aqueous humor outflow, while minimally invasive ab-interno techniques are lacking.
Innovation Solution
The development of ocular delivery systems that allow for minimally invasive, single-handed, single-operator access to Schlemm's canal using a universal handle with a cannula and drive assembly, enabling the delivery of ocular devices or fluid compositions to dilate and disrupt the canal and surrounding tissues, maintaining patency without interfering with transmural fluid flow.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If ab-externo approach (viscocanalostomy, canaloplasty) is used to access Schlemm's canal, then the canal can be dilated and aqueous humor outflow can be increased, but the surgical procedure becomes invasive and challenging to perform
Solution Approach 1:
The patent inverts the traditional ab-externo approach by using an ab-interno approach, where the cannula is inserted from inside the anterior chamber through the trabecular meshwork to access Schlemm's canal from the interior rather than from the exterior of the eye. This reversal makes the procedure minimally invasive while maintaining the ability to dilate the canal and increase aqueous humor outflow
Solution Approach 2:
The delivery system employs a nested structure where the cannula contains a collapsible balloon catheter that can be expanded within Schlemm's canal. The balloon is collapsed during insertion through the cannula, then expanded at the target location to dilate the canal, and finally deflated and removed, leaving the cannula to maintain patency
2Object-affected harmful factors
If minimally invasive ab-interno technique is used to access Schlemm's canal, then surgical trauma is reduced, but the ability to effectively dilate the canal and increase aqueous humor outflow is limited
Solution Approach 1:
The patent uses hydraulic principles by employing a fluid-filled collapsible balloon catheter that can be inflated with saline or viscoelastic fluid to dilate Schlemm's canal from within. This pneumatic/hydraulic expansion mechanism allows effective canal dilation through a minimally invasive ab-interno approach, simultaneously reducing surgical trauma while maintaining the ability to increase aqueous humor outflow
Solution Approach 2:
The system changes the physical state and parameters of the delivery mechanism by using a balloon that transitions from a collapsed low-volume state during insertion to an expanded high-volume state during dilation, and then back to collapsed state for removal. This parameter change enables the system to perform effective canal dilation while minimizing surgical trauma
3Difficulty of detecting and measuring
If traditional surgical methods are used to create access to Schlemm's canal, then the canal can be accessed for device delivery, but the risk of infection and surgical complications increases
Solution Approach 1:
The patent inverts the traditional surgical approach by accessing Schlemm's canal from the interior of the eye through the trabecular meshwork rather than creating external incisions and flaps. This ab-interno approach minimizes disruption to the ocular surface and reduces the risk of infection and surgical complications while maintaining effective canal accessibility for device delivery
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
These systems facilitate efficient and precise delivery of ocular devices and fluids to reduce intraocular pressure, treat conditions like glaucoma, and minimize surgical trauma and infection risk, allowing for combined cataract and glaucoma surgery in a single sitting.
Implementation Method 1
The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by dilating the canal, disrupting juxtacanalicular meshwork and the adjacent wall of Schlemm's canal, and increasing aqueous permeability
Data Source
AI summary
Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.